A 74-year-old man underwent TAPP for a left indirect inguinal hernia (M2, according to EHS classification) with a Parietex (Medtronic plc. Dublin, Ireland) mesh measuring 13 × 9 cm. Recurrence was confirmed 5 years postoperatively. To diagnose the type of recurrence and clarify the location of the defect, the orifice was inspected using laparoscopy and a 2-cm indirect hernia was detected inferior to the lower edge of the mesh (a and b). Next, the skin was incised for the anterior open approach. The inguinal canal was opened in a standard manner, and the hernia sac was identified under increased pneumoperitoneum. After isolating the tissues surrounding the hernia sac, adequate space was secured in the preperitoneal cavity to insert a plug. Then, the plug was inserted into the defect following sac invagination under reduced pneumoperitoneum. An XL-sized PerFix (BD, Franklin Lakes, NJ, USA) plug (height 3.8 cm, diameter 5.1 cm) was fixed to the transverse fascia and the previous mesh with six interrupted stitches using absorbable sutures. Finally, the overlap was confirmed to sufficiently cover the myopectineal orifice, and the plug was inverted under the peritoneal membrane using laparoscopy with increased pneumoperitoneum (). The entire operation time was 1 h and 58 min. No complication was reported in the postoperative course nor was re-recurrence at 3 months postoperatively.